Active NPI
Dominga Teresa Moyer
- Intellectual & Developmental Disabilities Psychologist
- Chico, CA
National Provider Identifier
1003653080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual & Developmental Disabilities Psychologist
- License
- 4034
- Practice address
- 1180 E 1St Ave
Chico, CA 95926-2404 - Phone
- (530) 521-8869
- NPI assigned
- Jul 9, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4034 | CA | |
| Cognitive & Behavioral Psychologist | 103TB0200X | 4034 | CA | |
| Counseling Psychologist | 103TC1900X | 4034 | CA | |
| Intellectual & Developmental Disabilities Psychologist | 103TM1800X | 4034 | CA | Primary |
Addresses
Primary practice location
1180 E 1St Ave
Chico, CA 95926-2404
Mailing address
1180 E 1St Ave
Chico, CA 95926-2404
Phone (530) 521-8869
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4034 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1720483200000",
"number": "1003653080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1180 E 1ST AVE",
"city": "CHICO",
"state": "CA",
"postal_code": "959262404",
"telephone_number": "530-521-8869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1180 E 1ST AVE",
"city": "CHICO",
"state": "CA",
"postal_code": "959262404",
"telephone_number": "530-521-8869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYER",
"first_name": "DOMINGA",
"middle_name": "TERESA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-09",
"last_updated": "2024-07-09",
"certification_date": "2024-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "4034",
"primary": false
},
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "CA",
"license": "4034",
"primary": false
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CA",
"license": "4034",
"primary": false
},
{
"code": "103TM1800X",
"taxonomy_group": "",
"desc": "Psychologist, Intellectual & Developmental Disabilities",
"state": "CA",
"license": "4034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chico, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.